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Where to buy health insurance in Florida

If you don't have health insurance benefits through your employer, you have health coverage options:

  1. Through a public or private market
  2. Through an authorized agent in person or by phone
  3. Directly from an insurance company

You may also be eligible for help through state or federal programs, such as Florida KidCare for Children.

Buy insurance in the Florida marketplace

Thirteen states have their own health insurance exchange (including the District of Columbia) or "marketplace." However, Florida is among 38 states that do not have their own government stock exchange and instead collaborate with the federal government to offer health insurance through the marketplace. The market is exactly as the name suggests; It is a place where anyone is free to search for an insurance plan that meets their unique needs.

The market operates as follows:

  1. Each fall there is an open enrollment period, which typically lasts about 90 days. Before this time, clients have the freedom to explore the market and explore all the different plan options that insurance companies offer. However, customers have to wait until the first day of the open enrollment period to purchase health plans.
  2. Open enrollment is the only time of the year when most Americans can buy health insurance or change their current plan. In some cases, you may qualify for a special enrollment period.
  3. All insurance offered through the Marketplace meets the "minimum basic coverage" requirements stipulated by the ACA.

There are four main levels of plans available in the market: Platinum, Gold, Silver and Bronze. These plan levels, often called "metallic levels," vary based on their actuarial value. The actuarial value affects the amount you are responsible for paying in personal expenses versus what your plan will pay (on average). While plans with lower actuarial values ​​often have lower premiums, they are generally combined with higher out-of-pocket expenses (such as subscriptions and deductions). When choosing a plan, it is important to understand how deductions will affect your premiums.

It's equally important to make sure you buy the ACA compliant Florida plan, meet your medical needs, and stay within your budget. If everything starts to get a little confusing, don't panic. We are here to help.

Florida Out of Stock Insurance

There are some important differences between an over-the-counter plan and an over-the-counter plan.

  1. In addition to meeting the prerequisites stipulated by the ACA, marketplace (or exchange) plans should also be considered Qualified Health Plans (QHP), which must meet an additional set of standards. These standards may exceed those of the ACA. OTC plans must meet the ACA requirements, but do not have to qualify for health plans. However, many insurance companies choose to offer approved QHPs both on and off the exchange. In fact, many companies offer stronger plans and extensive OTC coverage.
  2. Unlike Marketplace plans, OTC plans do not qualify for premium subsidies or cost-sharing support.
  3. The same policies that are sold on the market and on the exchange will be sold at the same price. However, not all plans sold in the market will be available OTC and vice versa. Some insurance companies do not participate in the market and only offer OTC plans. Insurance agencies with a private market, such as HealthMarkets, include exchange plans on and off the exchange.

In some states, plans are cheaper than exchange rates, and in others, they are cheaper to switch. Either way, an agent licensed to sell exchange policies should be able to help determine whether the exchange policy best meets your needs.

Whether you choose to buy your insurance on or off the stock exchange, ACA has expanded your options and improved quality coverage (through mandates such as a guaranteed issue). Take your time to find the policy that best meets your specific needs.

If you don't qualify for assistance, it probably makes sense to go ahead with the exchange, as OTC plans don't qualify for benefits. But what should you know about support before moving forward?

Florida benefits and other ways to get help with the cost of health insurance

Low- to middle-income individuals and families seeking market coverage may qualify for premium tax credits or cost-sharing reductions. These benefits help reduce monthly payments and out-of-pocket expenses, such as copays and deductions. Here are some common questions asked by people seeking help with the cost of their health care.

Do I have to wait until the end of the tax year to receive my preferred tax credit?

No. An insurance company tax credit can be paid up front or as a lump sum when filing taxes to reduce the customer's monthly insurance premium payments. These benefits are based on income and are provided to those who achieve between 100 and 400 percent of the federal poverty level. The tax credit sets the cost of monthly installments at no more than 9.5 percent of household adjusted gross income.

What is the difference between reduced participation costs and excellent tax credit?

While tax credits lower the cost of health insurance premiums, cost-sharing cuts do the same for personal expenses, such as coinsurance, copays, and deductions. These reductions are available to clients with Silver plans that reach between 100 and 250 percent of the federal poverty level.

Cost-sharing reductions are only available to individuals enrolled in a Silver plan through the Health Insurance Marketplace, while Premium Tax Credits can be applied to any stock exchange or market plan (regardless of catastrophic plans ). For this reason, premium tax credits are more flexible than cost-sharing cuts.

Can I still get premium tax credits if I qualify for Medicaid?

People with incomes between 100 and 138 percent of the poverty line who are eligible for Medicaid do not qualify for premium tax credits. They could qualify for premium tax credits if they didn't qualify for Medicaid because their state didn't expand Medicaid. Certain limited Medicaid coverage is not considered "minimum basic coverage" and therefore will not deny that person receipt of premium tax credits.